I never took a pill without a prescription. Each month, I gave my two forms of ID to the pharmacist and signed for my script. If I couldn’t take my medicines, I’d cry and rage and whimper. I was addicted to opiates, accidentally. I didn’t know how to survive without them. I broke my addiction, but wouldn’t have if I had any other option. People would call me a good addict, not knowing that qualifier is meaningless.

When I was a freshman in college, I got sick. Despite being an English major, I didn’t have words for the pain my body was experiencing. My joints had mysteriously started seizing up. I collapsed on a crowded bus. I exhausted the expertise at the university health center after my first two visits and began a grand tour of the local hospital, visiting with specialists who would spend five minutes listening to me, order a vampire’s worth of blood tests, and then dismiss me when the tests proved inconclusive. The specialists would only agree on one thing: I was definitely exaggerating how bad it was, and I was probably just homesick and depressed. After a couple of months, I finally got shoved over to a rheumatologist; they’d  ruled out anything neurological and begrudgingly agreed that maybe I wasn’t just faking my illness for attention. I was walking with a cane by that point and 87 pounds. If I was faking, they said, I was doing a damn good job.

I remember my rheumatologist’s office, tucked away in a strip mall. He had one nurse, and the exam table was handmade, built out of two by fours with pleather covering thin cushioning. He didn’t have any comforts or any extra furniture. Just the empty exam room, where I waited alone and scared.

I told him that I had so much pain that I would wake up crying at night. I told him I was scared that I couldn’t stay in college, and that I was barely functioning. He was so nice and so sympathetic. He reviewed the ample blood tests, suggested a few medicines, but warned me that those drugs may not treat the symptoms and would take months to work, if they worked at all. He wasn’t optimistic.

I asked for answers. The only one he offered was another prescription: opiate painkillers. First one, then two a day. When it stopped working, he increased the dose or told me to take another. “You’re a smart girl. You can figure it out,” he told me. Controlling my pain was the only control I had, and I relished it.

A couple summers later, I was subletting a shitty college apartment. The original renters came to deliver some furniture for the next year. I came home and found my bottle of painkillers empty. I wasn’t totally naive; I knew there was value to my meds, but to me that value was living and sleeping without pain. To those people, I imagined, the value was selfish – monetary or a quick high.

I called my doctor crying. I thought I’d drown, that the pain in my body would consume me if there was nothing to numb it. It’d been less than a month since my last refill, and even though the state should have prevented it, I got a new prescription. My doctor told me he didn’t want me to withdraw yet. Whispers about an opioid epidemic were beginning, but I didn’t need be concerned about it. I was under supervision of a “real doctor,” unlike those people.

The last time I saw that doctor, I had just graduated college and was moving to a new city. I didn’t have a new doctor yet, so he gave me a prescription for 180 opiates. I didn’t know they made prescription bottles that large.

On my first appointment with a new doctor, a few months later, I asked about a refill. He visibly recoiled, and worriedly made notes on his computer. Apparently he didn’t consider a near-limitless supply of opioids to be a viable plan.  He told me he couldn’t authorize a refill, but did not tell me what to do instead or warn me of how bad it would get.

I staved off withdrawal for as long as I could, breaking my remaining pills in half, rationing them out as far as I could bear. Still, the supply dwindled, and my body immediately felt the lack. I spent three days shaking and crying in a bathtub, scared that I’d never feel normal. Electric shocks coursed through my body; I still don’t know what part was my disease and what was withdrawal. The pain and nausea were terrible, but nowhere near as bad as the shame. Only addicts withdrew. If my disease was legitimate, none of this would happen, right? I tried so hard to be a good patient. I did everything right. Earlier doctors screamed at me in my memories. The shame of withdrawal colored everything.  Maybe this misery was proof and punishment for not being good enough, not actually being sick.  Maybe I was a liar, a hypochondriac, or an addict. I didn’t know what part of my pain was valid anymore, or even if any of it was. When I reemerged, I couldn’t even tell anyone, too afraid of being judged as one of those people; those people that I finally understood.

For years, I blamed myself. Then I blamed my first doctor, and my second. Now, I’m not sure who’s guilty or if culpability matters at all. My first doctor cared that I was in pain. He wanted to make his patient comfortable, even if that came at the cost of addiction. My second doctor was scared of the opioid epidemic and didn’t want me to be caught up in it. Both of them thought they knew what was best for me, if they looked at me as a bundle of symptoms. But they refused to listen to me as a person and patient. If I was responsible for this misery and withdrawal, so were they. One doctor fed an addiction I didn’t even know I had. The next made me brutally aware, but left me alone to deal with the consequences. It isn’t some great feat of will that I didn’t turn to illicit means to keep the pain at bay; I was just lucky enough to finally receive a diagnosis and medically appropriate treatment.

Eventually, I was diagnosed with a rare autoimmune disease – Mixed Connective Tissue Disease. It’s still managed by a bevy of pills, punctuating the beginning and end of each day. Now, I interrogate my doctors, asking them every potential complication. Last year, I had surgery. I refused most painkillers, to my doctor’s dismay. He told me it was stupid to refuse. I couldn’t make him understand how scared I was of becoming addicted and withdrawing once again. Medicine doesn’t have time to listen to histories like mine.

In another timeline, I’m nineteen. My joints seize up. I’m scared, and I find a drug that helps. I take enough to get me through college, buying it from friends or strangers. I’m a bad addict, but no one knows that qualifier is meaningless.

Kae Roman is a sometimes academic, writer, and artist. Her therapist thinks she says 'sorry' too often, but she’s working on that. She lives in St. Louis with her partner and their menagerie of rescue animals.